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Comparative Study
. 2016 Jan;26(1):271-7.
doi: 10.1007/s00330-015-3809-x. Epub 2015 May 20.

High resolution pituitary gland MRI at 7.0 tesla: a clinical evaluation in Cushing's disease

Alexandra A J de Rotte  1 , Amy Groenewegen  2 , Dik R Rutgers  2 , Theo Witkamp  2 , Pierre M J Zelissen  3 , F J Anton Meijer  4 , Erik J van Lindert  5 , Ad Hermus  6 , Peter R Luijten  2 , Jeroen Hendrikse  2
Affiliations
Comparative Study

High resolution pituitary gland MRI at 7.0 tesla: a clinical evaluation in Cushing's disease

Alexandra A J de Rotte et al. Eur Radiol. 2016 Jan.

Abstract

Objective: To evaluate the detection of pituitary lesions at 7.0 T compared to 1.5 T MRI in 16 patients with clinically and biochemically proven Cushing's disease.

Methods: In seven patients, no lesion was detected on the initial 1.5 T MRI, and in nine patients it was uncertain whether there was a lesion. Firstly, two readers assessed both 1.5 T and 7.0 T MRI examinations unpaired in a random order for the presence of lesions. Consensus reading with a third neuroradiologist was used to define final lesions in all MRIs. Secondly, surgical outcome was evaluated. A comparison was made between the lesions visualized with MRI and the lesions found during surgery in 9/16 patients.

Results: The interobserver agreement for lesion detection was good at 1.5 T MRI (κ = 0.69) and 7.0 T MRI (κ = 0.62). In five patients, both the 1.5 T and 7.0 T MRI enabled visualization of a lesion on the correct side of the pituitary gland. In three patients, 7.0 T MRI detected a lesion on the correct side of the pituitary gland, while no lesion was visible at 1.5 T MRI.

Conclusion: The interobserver agreement of image assessment for 7.0 T MRI in patients with Cushing's disease was good, and lesions were detected more accurately with 7.0 T MRI.

Key points: Interobserver agreement for lesion detection on 1.5 T MRI was good; Interobserver agreement for lesion detection on 7.0 T MRI was good; 7.0 T enabled confirmation of unclear lesions at 1.5 T; 7.0 T enabled visualization of lesions not visible at 1.5 T.

Keywords: Cushing’s disease, pituitary; Magnetic resonance imaging; Pituitary ACTH hypersecretion; Pituitary adenoma; Pituitary gland.

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Figures

Fig. 1
Fig. 1
The 1.5 T and 7.0 T MR images of a 56-year-old woman with Cushing’s disease. The lesion marked in the 1.5 T images (white arrowhead) was identified by only one of the two observers. Note that this lesion was only visible on one slice. After consensus with a third observer, the final decision was “no lesions”. The lesion marked in the 7.0 T images (white arrow) was identified by both observers
Fig. 2
Fig. 2
The transversal 7.0 Tesla T1 MPIR TSE images before and after contrast enhancement of a 42-year-old male diagnosed with Cushing’s disease. On the 1.5 T images, not demonstrated, there was no lesion detected. On 7.0 T MRI there was a lesion detected (arrowhead) in the left side of the pituitary gland. During surgery, an ACTH producing microadenoma was removed from the left side of the pituitary gland
See this image and copyright information in PMC

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